Related Experiment Video
Updated: Aug 24, 2026
Tissue Preparation Techniques for Contrast-Enhanced Micro Computed Tomography Imaging of Large Mammalian Cardiac Models with Chronic Disease
Published on: February 8, 2022
Pericardial abscess occurring after tuberculous pericarditis: image morphology on computed tomography and magnetic
1Department of Cardiovascular Radiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi 110029, India.
Aim:
To study the image morphology on computed tomography (CT) and magnetic resonance imaging (MRI) of pericardial abscess, an uncommon complication of tuberculous pericarditis.
Material And Methods:
In a 9-year period, 120 patients with clinical and imaging features of constrictive pericarditis were retrospectively reviewed. Of them, 13 patients (age range, 1-51 years; seven females, six males), who had a pericardial mass on echocardiography, and were subjected to CT (11 patients) and MRI (7 patients), were included as subjects of the present study. Five patients underwent both the investigations. The intra-lesional morphology, location, extent, mass effect on adjacent cardiac chambers, secondary effects on the atria and venae cavae, and pericardial thickness were studied. Histopathological confirmation of tubercular infection was available in nine patients. In the remaining four patients, the diagnosis was based on typical extra-cardiac manifestations of tuberculosis.
Results:
A total of 15 abscesses were detected. CT showed a lesion with a hypodense core and an enhancing rim in all patients. On spin-echo T1-weighted MRI, 57% of the paients had a lesion with a hyperintense core, suggesting an exudative process. Seventy-one percent of patients showed a lesion with a hyperintense core on T2-weighted MRI, while one lesion was hypointense. Post-gadolinium MRI was performed in two patients and showed an enhancing rim in both, with enhancing septa in one. The predominant site of involvement was in the right atrioventricular (AV) groove (77%). Localized tamponade, suggested by the presence of mass effect on an adjacent cardiac chamber, was noted in nine (69%) cases, with proximal atrial dilatation in 78% of them. Four other patients (31%) had atrial dilatation without a localized mass effect.
Conclusion:
Pericardial abscess is an uncommon complication of constrictive pericarditis. Tuberculosis was responsible for abscess formation in all cases in this study. The majority of the lesions are located in the right AV groove with imaging features suggestive of localized tamponade. The presence of a hypointense core on T2-weighted MRI may suggest a tubercular aetiology.
Insights
Pericardial abscess, a rare complication of tuberculous pericarditis, often presents in the right atrioventricular groove. Imaging findings on CT and MRI can suggest tuberculosis as the cause.
Area of Science:
- Cardiology
- Radiology
- Infectious Diseases
Background:
- Pericardial abscess is an infrequent complication of tuberculous pericarditis.
- Constrictive pericarditis can be associated with pericardial abscess formation.
Purpose of the Study:
- To characterize the computed tomography (CT) and magnetic resonance imaging (MRI) features of pericardial abscess.
- To identify imaging indicators of tuberculous etiology in pericardial abscess.
Main Methods:
- Retrospective review of 120 patients with constrictive pericarditis over 9 years.
- Analysis of imaging (CT and MRI) in 13 patients with pericardial mass.
- Evaluation of lesion morphology, location, extent, and effects on cardiac structures.
Main Results:
- 15 pericardial abscesses were detected.
- CT showed hypodense core with enhancing rim; MRI revealed hyperintense core on T1/T2-weighted images in most cases.
- Abscesses predominantly located in the right atrioventricular groove, often causing localized tamponade and atrial dilatation.
Conclusions:
- Tuberculosis was the cause of all pericardial abscesses in this cohort.
- Imaging features, particularly a hypointense core on T2-weighted MRI, may suggest a tuberculous origin.
- Right AV groove location and signs of localized tamponade are common findings.
Related Concept Videos
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:28Imaging Studies for Cardiovascular System V: CT
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:23Rheumatic Heart Disease I: Introduction
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...